Peter Attia· MD
so so we had 40 dogs come into the study for their first exam that was our target number we ended up having 24 go all the way through the study
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The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
so so we had 40 dogs come into the study for their first exam that was our target number we ended up having 24 go all the way through the study
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The "high risk" framing here is the right call. I've had three patients ask about rapa this month and none of them grasped the immunosuppression tradeoff until I walked them through it.
The PEARL trial framing in the dossier is the clearest writeup I've seen for a non-specialist. Worth linking from the AMA pages too.
I'm on 6mg/week, year two. Tracking IL-6, fasting glucose, lipids. Happy to share the spreadsheet if Whalespan wants longitudinal user data.
The dosing variance across the advocate camp is staggering. 3mg, 5mg, 8mg, biweekly, weekly… brief is right that "monitor or specialist only" is the responsible read.
Now bringing it back to the dogs one of the challenges of course in leaping from mice to dogs is mortality becomes difficult to study you have an animal that lives a lot longer whereas mice you know you can get a longevity answer in you know months if you select them correctly in dogs if you want to study them for true hard outcome of you know death it seems they want to do so so you pick a proxy well you can yeah yeah I'm saying I'm saying like the shortest path would be let's look at organ function or something else right
lifespan is our primary endpoint right which is important because i think if i think this is the first clinical trial that has lifespan you know in a healthy or normal health status population as the endpoint
lifespan is our primary endpoint but we are tracking multiple secondary endpoints to give us a picture of is rapamycin broadly impacting the aging process so we're looking every six months the dogs get echocardiograms to look at heart function the dogs will be fitted with activity monitors periodically to look at spontaneous activity every six months the dogs will get cognitive assessments to look at cognitive function we're getting blood chemistry serum metabolome fecal microbiome and of course we'll be tracking disease incidents as these dogs get older
I'm not sure that lifespan so even though we're powered for lifespan that's our primary Endo I'm honestly not sure that's the most important end point for evaluating potential efficacy of rapy in in dogs or people
I'm not sure that lifespan so even though we're powered for lifespan that's our primary endpoint I'm honestly not sure that's the most important endpoint for evaluating potential efficacy of rapamycin in in dogs or people right I mean I think we want to think about this more broadly speaking in the sense that there may be some health span metrics that are particularly and potently positively impacted by
and so absent really good biomarkers for some of these Hallmarks of Aging I think we still have a ways to go before we could say the following Ramy is gero protective towards humans and taking Ramy according to protocol X will add years to human life and presumably improve health span uh that's a that's an enormous claim um where I say a lot of work still needs to be done and some of that work I think needs to be done in other animal models such as what Matt cllin is doing in the dog aging project
Rapamycin extends median and maximum lifespan in mice across multiple lab strains and dosing protocols.
Rapamycin will extend human lifespan by 5+ years at standard weekly dosing.
Weekly rapamycin dosing in healthy adults shows favorable safety and immune markers in early observational data.
Chronic low-dose rapamycin imposes an immune trade-off that outweighs the longevity hypothesis for most healthy adults.
mTORC1 inhibition is the mechanistic backbone for rapamycin's healthspan effects in mammals.
The PEARL trial showed an acceptable 48-week safety profile in healthy adults on weekly rapamycin.